Polycystic Ovary Syndrome (PCOS) is the most common hormonal disorder among Indian women of reproductive age. Studies estimate that 20-25% of Indian women are affected — yet it remains widely misunderstood, often dismissed as “just irregular periods.”
If you’ve been told to simply “take birth control pills” or “just lose weight,” you’re not getting the full picture. PCOS is a complex, multi-system condition — and effective treatment requires understanding your specific type.
What Is PCOS, Really?
Despite its name, PCOS is not primarily an ovarian problem. It’s a metabolic and hormonal condition that affects your entire body — your insulin levels, inflammation markers, stress hormones, gut health, skin, hair, weight, mood, and fertility.
The three core drivers are:
- Excess androgens (male hormones like testosterone)
- Insulin resistance (affects up to 70% of women with PCOS)
- Chronic low-grade inflammation
These three factors interact differently in different women — which is why there isn’t a one-size-fits-all treatment.
The 4 Types of PCOS
Understanding your type is the most important step toward effective management. Each type has a different root cause and responds to different interventions.
Type 1: Insulin-Resistant PCOS (Most Common)
This is the most prevalent type, affecting approximately 70% of women with PCOS.
How it works: High insulin levels signal the ovaries to produce excess testosterone. This disrupts ovulation, promotes weight gain, and creates a cycle that’s difficult to break with willpower alone.
Key signs:
- Weight gain, especially around the abdomen
- Intense sugar and carb cravings
- Fatigue, especially after meals
- Difficulty losing weight despite effort
- Skin darkening in folds (acanthosis nigricans)
- Skin tags
What helps: Low-glycaemic diet, strength training, inositol supplementation, adequate sleep, reducing refined carbs and sugar.
Type 2: Inflammatory PCOS
Chronic inflammation triggers the adrenal glands and ovaries to produce excess androgens. This type is often missed because many women with inflammatory PCOS are not overweight.
Key signs:
- Fatigue that doesn’t improve with rest
- Joint pain, headaches
- Skin issues — eczema, rashes, unexplained hives
- Digestive problems — bloating, IBS-like symptoms
- Elevated CRP or ESR in blood tests
What helps: Anti-inflammatory diet (rich in omega-3, turmeric, leafy greens), gut healing protocol, eliminating food sensitivities, stress reduction.
Type 3: Adrenal PCOS
This type is driven by chronic stress rather than insulin. The adrenal glands produce excess DHEA-S (an androgen), while other androgens from the ovaries remain relatively normal.
Key signs:
- Elevated DHEA-S with normal testosterone
- High anxiety and feeling of overwhelm
- Sleep disruption
- Often thin or normal weight
- Symptoms worsen during stressful periods
What helps: Stress management (meditation, pranayama, yoga nidra), adaptogenic herbs (ashwagandha, shatavari — with medical guidance), sleep optimisation, avoiding over-exercising.
Type 4: Post-Pill PCOS
Symptoms appear after discontinuing hormonal contraceptives. The body needs time to re-establish its natural hormonal rhythm, and some women develop temporary PCOS-like symptoms during this transition.
Key signs:
- Periods don’t return for months after stopping the pill
- Acne resurgence
- Hair thinning
- LH:FSH ratio may be elevated temporarily
What helps: Patience (it can take 3-12 months), zinc and magnesium supplementation, supporting liver detoxification, seed cycling, balanced nutrition.
Common PCOS Symptoms at a Glance
Not every woman experiences all symptoms. But if you have three or more of these, it’s worth getting evaluated:
- Irregular periods (cycles longer than 35 days or fewer than 8 cycles/year)
- Absent periods (amenorrhoea)
- Heavy or prolonged bleeding
- Acne, especially along the jawline and chin
- Excess facial or body hair (hirsutism)
- Hair thinning or loss on the scalp
- Weight gain or extreme difficulty losing weight
- Mood swings, anxiety, or depression
- Fatigue and brain fog
- Difficulty conceiving
Why Medication Alone Isn’t Enough
Birth control pills are the most commonly prescribed treatment for PCOS in India. While they can regulate periods and reduce acne, they mask symptoms without addressing the root cause.
Common issues with a medication-only approach:
- Symptoms return (often worse) when you stop the pill
- Underlying insulin resistance continues to worsen
- Inflammation goes unaddressed
- The gut microbiome — which plays a role in hormone metabolism — is not supported
- Nutritional deficiencies may be worsened by long-term pill use
A comprehensive approach should include:
| Pillar | What It Addresses |
|---|---|
| Nutrition | Insulin sensitivity, inflammation, gut health |
| Movement | Insulin regulation, stress relief, hormonal balance |
| Stress Management | Cortisol-androgen connection |
| Sleep | Hormone production and recovery |
| Supplements | Targeted support for your specific PCOS type |
| Medical Treatment | When needed, alongside lifestyle changes |
What Tests Should You Get?
If you suspect PCOS, ask your doctor for these investigations:
- Hormonal panel — LH, FSH, testosterone (total and free), DHEA-S, prolactin
- Metabolic panel — fasting insulin, fasting glucose, HbA1c, lipid profile
- Thyroid function — TSH, free T3, free T4 (thyroid issues can mimic PCOS)
- Inflammatory markers — CRP, ESR
- Vitamin levels — Vitamin D, B12, iron/ferritin
- Pelvic ultrasound — to check ovarian morphology
Can PCOS Be Reversed?
“Reversal” means different things in different contexts. While PCOS may have a genetic component, the symptoms can absolutely be managed and even resolved with the right approach.
Women in our programs have experienced:
- Natural period restoration — many for the first time in years
- Sustainable weight loss without extreme dieting
- Clear skin without dependence on medication
- Natural conception after being told they’d need IVF
- Dramatic improvement in energy and mood
The key is addressing your specific root cause, not following generic advice.
Start Taking Control
PCOS doesn’t have to define your health, your weight, or your fertility. With the right understanding of your type and a personalised plan, your body can find its balance again.
The first step is always awareness. Now you have it.
